Comparison of the Efficacy and Safety of Video-assisted Thoracoscopic Surgery with the Open Method for the Treatment of Primary Pneumothorax in Adults

Objective: To determine whether video-assisted thoracoscopic surgery is as effective as the traditional open method through axillary thoracotomy for the management of primary spontaneous pneumothorax in adults.

Materials And Methods: This retrospective study was conducted at King Hussein Medical Center in the period between March 2002 and March 2007. Eighty-two patients were included in this study. The patients were divided in two groups: group A, which included patients who underwent video-assisted thoracoscopic surgery; and group B, which included patients who underwent open technique through axillary thoracotomy. Efficiency of the procedure, operative time, postoperative complications, length of hospital stay, time to return to work and recurrence were compared between the two groups.

Results: There were 79 males (96.3%) and 3 females (3.7%) with a mean age of 23.7 +/- 4.2 years for group A patients and 24.2 +/- 4.6 years for group B patients (range 16-37 years). Forty-one patients (50%) underwent video-assisted thoracoscopic surgery (group A), and 41 patients (50%) underwent open surgical technique through axillary thoracotomy (group B). Postoperative complication occurred in 8 patients (19.3%) from among those who underwent open technique and 6 patients (14.6%) from among those who underwent thoracoscopic technique. There was no perioperative mortality in both groups. Postoperative pain, volume of blood loss, period of air leak and hospital stay were less in group A, although the operative time was less in group B.

Conclusion: Video-assisted thoracoscopic surgery is an efficient and safe method for the treatment of patients with primary pneumothorax in the adults.